What EKG finding is classically associated with pulmonary embolism?

What EKG finding is classically associated with pulmonary embolism?

• A. S1Q3T3 pattern
• B. New ST elevations in II
• C. Atrial fibrillation
• D. Left axis deviation

Answer: (C)

Pulmonary embolism strains the right heart, which can irritate the atrial tissue and create rhythm disturbances. This atrial irritation and the accompanying hypoxemia make atrial fibrillation a recognized, practical EKG finding in the setting of acute PE. While classic teaching often mentions the S1Q3T3 pattern as associated with PE, that pattern is neither highly sensitive nor specific and may be absent in many cases. A rhythm disturbance like atrial fibrillation is a tangible clue you can identify on the tracing and fits with the idea of atrial and right-heart involvement in PE. The other options are less consistent with PE: new ST elevations in the inferior leads point more toward an acute inferior MI, and left axis deviation is not a characteristic feature of PE. Remember, the EKG can help raise suspicion for PE but is not diagnostic on its own.

Pulmonary embolism strains the right heart, which can irritate the atrial tissue and create rhythm disturbances. This atrial irritation and the accompanying hypoxemia make atrial fibrillation a recognized, practical EKG finding in the setting of acute PE. While classic teaching often mentions the S1Q3T3 pattern as associated with PE, that pattern is neither highly sensitive nor specific and may be absent in many cases. A rhythm disturbance like atrial fibrillation is a tangible clue you can identify on the tracing and fits with the idea of atrial and right-heart involvement in PE. The other options are less consistent with PE: new ST elevations in the inferior leads point more toward an acute inferior MI, and left axis deviation is not a characteristic feature of PE. Remember, the EKG can help raise suspicion for PE but is not diagnostic on its own.